Helping patients work out what is real

People with diagnoses such as psychosis, schizophrenia and bipolar disorder frequently have experiences that are not shared by others. For example, they may hear voices or have unusual beliefs.

They may not accept the explanation that they are suffering from a mental illness - and increasingly, psychologists are agreeing with them. Instead, some mental health professionals argue that we are all vulnerable to developing such beliefs and experiences at times, and the dividing line between mental illness and mystical or spiritual crises is not clear-cut.

Clinical psychologist Isabel Clarke discussed her work at the Annual Conference of the Society's Division of Clinical Psychology in Birmingham today.

She runs a successful programme of groups on a psychiatric ward in which patients are encouraged to see their experiences of losing touch with what she calls ‘shared reality’ as something that can happen to any of us under stress. In fact, it can have a spiritual and creative dimension and lead to positive changes in your life. The problem arises when you are unable to find your way back from ‘unshared reality'.

Isabel finds that this kind of explanation can raise people’s morale and encourage them to learn new methods of coping with stress. People taking part in the groups have reported relief at being able to talk about and understand their distressing experiences in a way that reduces stigma and gives them self-help tools for the future.

Isabel Clarke, who is the author of Madness, Mystery and the Survival of God, says that initial evaluation of the programme has been very positive. "It has been successful in engaging some people who were very difficult to reach, and there are plans to develop an expanded version of the group for use in the community."

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